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SB 328

Maryland Medical Assistance Program and Health Insurance - Annual Behavioral Health Wellness Visits - Coverage and Reimbursement

2025 Regular Session Introduced by Malcolm Augustine

SB 328 mandates Maryland Medicaid and insurers cover annual preventive behavioral health wellness visits to improve early mental health screening access and reduce care barriers.

Hearing 2/04 at 1:00 p.m.
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Bill Summary · SB 328

Legislative bill overview

SB 328 requires Maryland's Medical Assistance Program (Medicaid) and health insurers to cover and reimburse annual behavioral health wellness visits. The bill establishes coverage mandates for preventive behavioral health screening and assessment services, ensuring these visits are treated as covered benefits without cost-sharing barriers for enrollees.

Why is this important

Preventive behavioral health services can identify mental health and substance use issues early, potentially reducing emergency department visits, hospitalizations, and crisis interventions. Ensuring insurance coverage removes financial barriers that currently prevent many Marylanders from accessing routine behavioral health screening, particularly low-income populations relying on Medicaid.

Potential points of contention

  • Insurance industry cost concerns: Insurers and payers may argue that mandating coverage increases premiums and administrative costs, particularly if defining "wellness visit" parameters is vague
  • Reimbursement rate disputes: Disagreement over what constitutes appropriate reimbursement rates for behavioral health providers, which could affect provider participation and service availability
  • Scope and definition clarity: Ambiguity about what qualifies as an "annual behavioral health wellness visit" versus other covered services, potentially creating coverage disputes and inconsistent implementation
  • Provider capacity: Questions about whether existing behavioral health providers have sufficient capacity to absorb increased demand from newly covered annual visits

Compiled from official sources — confirm details with the bill’s official record.

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